Active NPI
Julieann Drake, PTA
- Physical Therapy Assistant
- Fernandina Beach, FL
National Provider Identifier
1821445842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA26654
- Practice address
- 1885 S 14TH St
Fernandina Beach, FL 32034-3033 - Phone
- (904) 277-4449
- Fax
- (904) 277-4177
- NPI assigned
- May 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA26654 | FL | Primary |
Addresses
Primary practice location
1885 S 14TH St
Fernandina Beach, FL 32034-3033
Mailing address
PO Box 1609
Callahan, FL 32011-1609
Phone (904) 277-4449
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AM305 | Other | FL | MEDICARE PTAN |
| DO0550 | Other | FL | RAILROAD MEDICARE |
| Y907M | Other | FL | BC/BS ID |
| Y327Q | Other | FL | BC/BS ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA26654 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nassau Physical Therapy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Callahan, FL
- NPI 1487872651
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464739200000",
"number": "1821445842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1609",
"city": "CALLAHAN",
"state": "FL",
"postal_code": "320111609",
"telephone_number": "904-277-4449",
"fax_number": "904-277-4177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1885 S 14TH ST",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320343033",
"telephone_number": "904-277-4449",
"fax_number": "904-277-4177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "JULIEANN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-19",
"last_updated": "2016-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA26654",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "AM305",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DO0550",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS ID",
"identifier": "Y907M",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS ID",
"identifier": "Y327Q",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fernandina Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.